Elbow Fractures in Children
If your child is an active athlete or just a toddler jumping on his bed, there's a good chance he'll fall, at home or on the playground, at some point.
These falls are usually harmless. But when a child falls with an outstretched arm, the speed of the fall combined with the pressure of hitting the floor may be enough to fracture, or break, a bone in the elbow. That way almost all fractures occur near the elbow joint.
These fractures that occur in the elbow, or around the elbow, account for about 10% of all fractures in children.
Anatomy
The elbow is a joint made up of three bones. The elbow flexes and stretches like a hinge.
The humerus
is the arm bone between the shoulder and elbow.The radius
is one of the bones of the forearm between the elbow and the wrist. When you place the palm of your hand up, the radius is on the forearm "thumb side" (lateral, external side).The ulna
is the other forearm bone between the elbow and wrist, is located next to the radius, and runs in the same direction. When you place the palm of your hand upward, the ulna is on the "pinky side" forearm (medial, inner side).
Types of Elbow Fractures
A child may experience a fracture in several places in the elbow area, including:
Above the elbow (supracondylar fracture).
The arm bone (humerus) breaks a short distance above the elbow. These fractures usually occur in children under the age of 8. This is the most common elbow fracture, and one of the most serious because it can lead to nerve damage and impaired circulation.In the elbow (condylar fracture).
This type of fracture occurs through one of the rounded prominences of the bone (condyles) at the end of the arm bone. Most occur through the external (lateral) prominence. These fractures require careful treatment, because they can alter the growth plate (epiphyseal plaque) and also the joint surface.
On the inside of the end of the elbow (epicondylar fracture).
At the top of each bony prominence is a projection called the epicondyle. Fractures at this point usually occur in the internal (medial) epicondyle in children ages 9 to 14.Growth plate (epiphyseal plaque).
The arm bone and the two forearm bones have growth plates located near the end of the bone. A fracture that alters the growth plate (epiphyseal plaque) can cause growth stoppage and/or deformity if not treated right away.Forearm fracture.
A dislocation of the elbow can completely break the radius head, and excessive force can cause a compression fracture in that bone as well. Fractures of the tip (olecranon) of the other forearm bone (ulna) are rare.Dislocation with fracture.
The ulna and radius are the bones of the forearm and border the bones of the hand at the wrist. A fracture of the ulna associated with a dislocation of the upper part of the radius in the elbow is called a Monteggia fracture. If the dislocation is not seen and only the fracture is treated, this can lead to a permanent impairment of elbow joint function.
My case
The case I am presenting to you today is about a male patient, barely 7 years old, who was brought by his mother on my last watch at 11 p.m. after the little one accidentally activated the washing machine at home and after introducing his arm he generated multiple fractures in his elbow and forearm.
After seeing the first x-rays we realized the severity of the case, not only was a fracture in a child, but also had a large dislocation that caused an increase in volume and pain at the level of the elbow almost intolerable, of course we were also concerned about the vitality of the limb, since in some cases the main arteries are also compromised.
It was difficult at first to immobilize him because the pain did not allow him to remain calm, but once in the operating room and with much patience our little friend finally sleeps while our hands are put into action in the middle of the night.
We started the procedure shortly after midnight and our plan was to restore not only the joint, but also the fractures he had in his elbow and forearm.
This area is of importance, since very close is a nerve that must always be identified before any procedure, it is the ulnar nerve, one of the main nerves of the hand along with the median nerve and the radial nerve.
After identifying it with great care and skill, we managed to relocate the fragments in their appropriate zone (anatomical location), it was like putting together a layman, but on an epic level the truth was true. After the placement of a screw and two wires, we achieved more than satisfactory results and the surgery was finished at 2 o'clock in the morning.
The next morning we visited our little and mischievous patient who did not remember anything curiously when the mother approached but the x-rays showed a great looking surgery, his scar and the mobility of the hand were totally adequate.
If you need recommendations or help in orthopedic surgery and traumatology do not hesitate to contact me.
Dr. Leopoldo Maizo - Orthopedic Surgeon
If you want to read more I invite you to visit my page:
Firma diseñada por @themonkeyzuelans, contáctalos vía Discord "themonkeyzuelans#9087"
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Posted from my blog with SteemPress : http://drmaizo.com/2018/09/21/surgeon-case-elbow-fractures-in-children/
A nice one. Certainly if there's any stressor that causes trouble to the growth plates, it might cause some permanent defects to the skeletal growth.
Of course friend, any joint fracture in children can cause problems in the growth plate, these problems are reduced by treating it but are not eliminated completely. Thank you for commenting.
Thanks for sharing some nice info :)
Nice work, reminds me of an olecranon case I helped with.
Thank you @ceattlestretch, elbow fractures are very common in children, what is not so common is that they are so severe. Some cases can last many hours in the operating room.
Ya, 2 hours is pretty quick
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hehehe, I see so many of these in our kids hospital.
I guess radial fractures and elbows are somely one of the things we do mostly on our kids here.
Good to see the process is the same by you guys!
It is true, most fractures in children are in the wrist and elbows, it is very common to fall after some games. Thank you for commenting @karinxxl, a big hug for you beautiful.